LSG showed the lowest readmission and reoperation rate, and RYGB patients had the highest mortality rate. Weight loss and comorbidity resolution were effectively achieved in RYGB and LSG patients.
Purpose
The aim of this study was to determine the real influence of bariatric surgery on the clinical evolution of patients infected with SARS-Cov-2 in the postoperative period.
Methods
We conducted a retrospective analysis including two groups of patients: those who presented COVID-19 before bariatric surgery and those who presented it within 3 months of postoperative. Primary outcome was related to the severity of COVID-19, measured by the following variables: presence of symptoms, need for hospitalization, ICU admission, and invasive ventilation. Laboratory markers for inflammatory response, glycemic status, and micronutrients were analyzed as secondary outcomes.
Results
From the 222 individuals operated on within the study period, only 66 (29.7%) presented COVID-19, 42 (18.9%) in the preoperative period and 24 (10.8%) after the procedure. Mean age was 36.3 ± 9.5 years and mean preoperative BMI was 39.9 ± 4.2 kg/m
2
. There were no statistically significant differences between the groups regarding symptoms presentation (92.9% × 87.5%,
p
= 0.66), need for hospitalization (11.9% × 16.7%,
p
= 0.713), ICU admission (4.8% × 4.2%,
p
= 1.000), and invasive ventilation (2.4% × 0.0%,
p
= 1.000). Regarding the quantitative variables, absolute lymphocyte count was significantly lower in the group who presented COVID-19 after surgery (1822.9 ± 482.2 × 2158.6 ± 552.9,
p
= 0.035).
Conclusion
Patients who had COVID-19 before and after sleeve gastrectomy did not differ with statistical significance for the presence of symptoms, need for hospitalization, ICU admission, and invasive ventilation.
Graphical abstract
This study confirms the poor prognosis of Gallbladder cancer even when incidentally diagnosed following cholecystectomy and supposes a 3-year prevalence estimate of 0.34% for incidental gallbladder cancer in our Center from Pernambuco State, Brazil.
Background: Laparoscopic cholecystectomy is widely used for cholelithiasis. Abdominal ultrasonography often precedes this operation and can prove diagnosis, as well as helps in showing possible complications during the perioperative period. Aim: Evaluate the description of variables of gallbladder and bile ducts present in reports of preoperative abdominal ultrasonography in cholelithiasis comparing with surgical findings. Methods: Were studied 91 patients who underwent elective laparoscopic cholecystectomy with previous abdominal ultrasonography. Variables such as identification and amount of gallstones involved were evaluated, both in preoperative ultrasonography and during surgery to evaluate sensitivity, specificity, concordance and positive and negative predictive values. Results: The reports did not mention diameter of vesicular light (98.9%), organ distension (62.6%), gallstone sizes (58.2%), wall thickness (41.8%) and evaluation of the common bile duct (39.6%). Ultrasound had high values for sensitivity, consistency and positive predictive value for identifying the presence/absence of gallstones: 98.8%, 96.7% and 97.8% respectively. As for the amount of stones, ultrasonography showed agreement in 82.7%, negative predictive value in 89.1% and specificity in 87.7%, with lower values for sensitivity (68.2%) and positive predictive value (65.2%). Conclusions: The ultrasound reports were flawed in standardization. Significant percentage of them did not have variables that could predict perioperative complications and surgical conversion.
there was a progressive loss of follow-up from the second postoperative year on. Among the factors analyzed, only the variable "excess weight" greater than 49.95kg in the preoperative period was associated with loss of medical-surgical follow-up. In the 48th month of the postoperative period, there was a higher prevalence of loss of medical-surgical follow-up for patients outside the perimeter of the city of Recife (51%, p=0.052).
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